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Preliminary experience of combined peri- and retrobulbar block in surgery for penetrating eye injuries

Published online by Cambridge University Press:  11 July 2005

L. Niemi-Murola ,
I. Immonen ,
H. Kallio  and
E.-L. Maunuksela
L. Niemi-Murola
Affiliation:
Helsinki University Hospital, Department of Anaesthesiology and Intensive Care Medicine, Helsinki, Finland
I. Immonen
Affiliation:
Helsinki University Hospital, Department of Ophthalmology, Helsinki, Finland
H. Kallio
Affiliation:
Helsinki University Hospital, Department of Anaesthesiology and Intensive Care Medicine, Helsinki, Finland
E.-L. Maunuksela
Affiliation:
Helsinki University Hospital, Department of Anaesthesiology and Intensive Care Medicine, Helsinki, Finland
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Extract

Summary

Background and objective: Regional anaesthesia has not been recommended as an anaesthetic method for penetrating eye injuries because it is suspected to aggravate the injury already present. After having successfully managed the treatment of a penetrating eye injury under combined peri- and retrobulbar block in an ASA IV patient, it was decided to evaluate this anaesthetic method further in the treatment of such emergency cases.

Methods: Twenty adult patients with penetrating eye injuries with a maximum wound length of 8 mm extending up to 4 mm posteriorly from the limbus were operated on under combined peri- and retrobulbar anaesthesia. Eighteen patients receiving general anaesthesia served as controls.

Results: The mean (range) volume injected for a satisfactory peribulbar retrobulbar block was 7.4 (6.5–8.0) mL, six patients needed an additional retrobulbar injection before surgery (2.9, range 2–4, mL). All patients receiving regional anaesthesia were satisfied with the anaesthetic method and the surgeons considered the surgical conditions as good. No problems relating to local anaesthesia were observed or reported by any of the patients.

Conclusions: In the hands of an experienced anaesthesiologist and under certain conditions, regional anaesthesia appears to be suitable for adult patients having penetrating eye injuries.

Keywords

ANAESTHESIA, conduction, nerve block, peribulbar block, retrobulbar blockANAESTHETICS, LOCAL, bupivacaine, lidocaineSENSE ORGANS, eyeSPECIALTIES, SURGICAL, ophthalmology
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 6 , June 2003 , pp. 478 - 481
Copyright
© 2003 European Society of Anaesthesiology

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